Community Advisory Board Research Articles

Abstract P383: Factors That Improve Young Men Participation in Rural Research: Findings From the Mississippi Core of the Risks Underlying Rural Areas Longitudinal (RURAL) Study

Introduction: Challenges in engaging and recruiting rural communities into health research stem from known barriers such as decreased healthcare awareness, less access to health research, community context and low education. Within rural communities, the demographic that is the most challenging to recruit is men ages 25-44 years. However, there is little data on what factors improve participation among young men in rural areas. The purpose of our study was to explore the reasons for the reluctance of men ages 25-44 to participate in research and identify factors can encourage their willingness to participate in the NHLBI’s Risk Underlying Rural Areas Longitudinal (RURAL) Study. Methods: In June 2022 and June 2023 respectively, the Mississippi (MS) Core of the RURAL Study conducted health fairs in Oktibbeha and Panola counties. Investigators used the health fairs as an opportunity to recruit participants for focus group interviews to explore questions related to men’s health awareness, health behaviors and likelihood to participate in the RURAL Study. Those recruited included community advisory board members and health fair attendees. One focus group in each county consisted of men only. Investigators conducted 4 virtual focus group interviews in each of the two counties. Thematic analysis was used to identify key themes and sub-themes. Results: Thirty-two (32) interviewees, including 25 women. participated in focus groups across the two counties (17 Oktibbeha,15 Panola). Four key themes and 8 subthemes were identified. Lack of health awareness, fear of harm, inability to see the benefits of participation, and lack of incentives were among the reasons men ages 25-44 do not participate in research in these rural areas. Investigators learned that providing health education with reassurance of no harm, promoting the benefits of participation to themselves their families and communities, providing meaningful incentives, and motivating them through influences from family, friends and third parties can encourage participation by men in this age group. Particularly, it was suggested health awareness investigators should host events explicitly for men (including small group question and answer sessions) and be visible in the community by going where the young men go such as barbershops, sporting events, gyms, and men’s organizational meetings and by staying in touch. Conclusion: In this study consisting of 8 focus groups conducted across two rural communities, key themes identified to improve young male participation in health research include: 1) addressing perceived concerns through awareness and reassurance of no harm,2) informing potential candidates for the study the benefits of participation, 3) maintaining a presence in the community through community engagement and 4) identifying and social motivators such as family, friends and third-party influencers.

Structural and relational factors for successful cross-sector collaboration in home visiting: a multiple case study

BackgroundAligning delivery and financing systems across sectors to create broader systems of care can improve the health and well-being of families experiencing adversities. We aimed to identify structural and relational factors for best practices to achieve successful cross-sector collaboration among home visiting programs in the United States.Materials and methodsWe used a multiple case study approach to identify best practices for successful cross-sector collaboration between home visitors and other community service providers. We selected five diverse exemplary cases with cross-sector collaboration with variation in implementing agency type and geographic location. Cases were selected using a positive deviance approach based on strong coordination and integration with different community service provider types identified from previous survey data. We conducted in-depth qualitative interviews with home visiting staff, community providers, and clients with a total of 76 interviews conducted from 2021 to 2022. We wrote memos to synthesize themes within each case through data triangulation using interview data, documents, and site visit observations. We compared themes across the five cases to create a cross-case synthesis of best practices for successful cross-sector collaboration.ResultsAcross the five cases, relational factors including leadership from all levels, champions across sectors, and shared goals between community providers were key factors for successful collaboration. Interpersonal relationships, coupled with the desire and capacity to engage, facilitated effective coordination to address families’ needs. At the structural level, shared data systems, written agreements, and co-location enabled care coordination activities. Community Advisory Boards provided a venue for developing partnerships, relationship-building, resource-sharing, and increasing awareness of home visiting.ConclusionsWe identified key elements of successful cross-sector collaboration across five case studies where home visitors coordinate care frequently and/or are structurally integrated with a range of providers. These learnings will inform future interventions to improve home visiting collaboration with other community providers to create a system of care to enhance family well-being.

Engaging people with lived experiences on community advisory boards in community-based participatory research: a scoping review protocol

IntroductionCommunity-based participatory research (CBPR) is a collaborative research approach that equally engages researchers and community stakeholders throughout all steps of the research process to facilitate social change and increase research...

Co-Partnering in a Virtual Photovoice Study Design With Older Adults: A Methodological Approach.

Gerontology offers a range of participatory research options with more commonly used community participatory-based research or participatory action research approaches. Photovoice's visual representation of lived experiences offers a unique opportunity for older adults to fully cocreate research. This article describes the process of codesigning a virtual photovoice study with older adults. The design process is described in 3 phases: codesign during the initial study design, throughout the study and data-collection process, and during dissemination. In this methodological article, substantive findings from an Institutional Review Board approved study where older adults created photos of the meaning of "home" through Zoom interviews are used to illustrate codesign in a virtual photovoice study. The process includes engagement with the Aging PCOR Learning Collaborative's Older Adult Subcommittee, Healthier Black Elders' Community Advisory Board, and older adults in the study. Work with advisory groups offered more dimensions to the study's planning, conduction, and dissemination, expanding the study's reach, inclusion, and framing. This collaboration created a greater exchange of dialogue and bidirectional flow of expression. The researcher became the subject, and older adults navigated study protocols. Older adults' increased self-reflection, spontaneous essays, and shared resources with the researcher expanded understanding. Older adults' revisions of this manuscript deepened content exploration. This article highlights the role of codesign throughout all a study's phases, where a researcher can work within the hyphen expanding connections with older adults. Their empowerment lets more complex, varied ideas develop.

Developing the Feast for the Future Program through a Community Visioning Process

Abstract: Background: Three tribal communities in the Southwestern United States have a long-standing partnership with the Johns Hopkins Center for Indigenous Health (JHCIH). Objectives: In response to community concerns about obesity, three tribal communities and Johns Hopkins Center for Indigenous Health partnered to develop culturally relevant plans for a new program. Methods: Using a "community visioning" process, a community advisory board (CAB) from each community identified opportunities, challenges, goals, and visions for their communities. The CABs consulted with experts in pediatrics, nutrition, food distribution, agricultural restoration, and community and school gardening. Results: The CABs developed seven components for Feast for the Future: 1) Edible School Gardens; 2) Traditional Food-ways Education Program; 3) Community Gardens, Orchards, and Greenhouses; 4) Farmers Markets; 5) Farmers Workshops; 6) Family Gardens; and 7) a Mobile Grocery Store. Conclusions: A community-based participatory action research (CBPAR) process was critical to developing a culturally appropriate program that built on community strengths.

A Hybrid Type 1 trial of a multi-component mHealth intervention to improve post-hospital transitions of care for patients with serious mental illness: Study protocol

BackgroundThe transition from acute (e.g., psychiatric hospitalization) to outpatient care is associated with increased risk for rehospitalization, treatment disengagement, and suicide among people with serious mental illness (SMI). Mobile interventions (i.e., mHealth) have the potential to increase monitoring and improve coping post-acute care for this population. This protocol paper describes a Hybrid Type 1 effectiveness-implementation study, in which a randomized controlled trial will be conducted to determine the effectiveness of a multi-component mHealth intervention (tFOCUS) for improving outcomes for adults with SMI transitioning from acute to outpatient care. MethodsAdults meeting criteria for schizophrenia-spectrum or major mood disorders (n = 180) will be recruited from a psychiatric hospital and randomized to treatment-as-usual (TAU) plus standard discharge planning and aftercare (CHECK-IN) or TAU plus tFOCUS. tFOCUS is a 12-week intervention, consisting of: (a) a patient-facing mHealth smartphone app with daily self-assessment prompts and targeted coping strategies; (b) a clinician-facing web dashboard; and, (c) mHealth aftercare advisors, who will conduct brief post-hospital clinical calls with patients (e.g., safety concerns, treatment engagement) and encourage app use. Follow-ups will be conducted at 6-, 12-, and 24-weeks post-discharge to assess primary and secondary outcomes, as well as target mechanisms. We also will assess barriers and facilitators to future implementation of tFOCUS via qualitative interviews of stakeholders and input from a Community Advisory Board throughout the project. ConclusionsInformation gathered during this project, in combination with successful study outcomes, will inform a potential tFOCUS intervention scale-up across a range of psychiatric hospitals and healthcare systems.Clinicaltrials.govregistration: NCT05703412

Evaluating the Impact and Effectiveness of Flint's Community Ethics Review Board (CBOP-CERB): A Pilot Study

Abstract: In recognition of the importance of evaluation for funding, research, and quality improvement, a longstanding Community Advisory Board in Flint Michigan embarked on a process to evaluate their impact. The Community-Based Organization Partners (CBOP)–Community Ethics Review Board (CERB) engaged a research team composed of an academic researcher (Solomon Cargill) and a community partner (Spencer) to obtain funding, design and implement an evaluation of the CBOP-CERB. This evaluation study yielded two evaluations of the CBOP-CERB, one with researchers who had engaged with the CBOP-CERB and the other with Flint area community residents. The results of these two evaluations can serve to show other Community Advisory Boards how to establish and expand their impact, establish their worth for future funding, and how to articulate, evaluate, and achieve their goals.

Bridging the Gap: Addressing Immigrant Health Through Community-initiated Screening Events

Abstract: Background: In areas of new-immigrant population growth, medical and social infrastructure may be lagging behind the needs of those who do not identify with the majority culture or language. Subsequently, information regarding this population's health status and access to care is limited. Montana's Hispanic population is one such group. Despite its low total population, the state has experienced unprecedented growth in the number of Spanish-speaking individuals and families over the last decade. Objectives: We utilized a community based participatory research framework to emphasize equal partnership between lay community members and researchers to ensure adherence to community priorities and strengthen trust between the two parties allowing for future collaboration. Based on community request, we designed four health screening events to provide needed health prevention services to the Hispanic community. Methods: Through collaboration with a Community Advisory Board, we created four health screening events to provide basic primary care services, including height and weight, blood pressure, diabetes, and mental health screenings. We partnered with a team of dental hygienists to provide oral preventive health. We conducted a cost-effectiveness analysis, comparing our approach to traditional health services. Study variables were analyzed using analysis of variance to examine differences in health outcomes between health screening events. Results: We screened 140 persons and found that 85.7% lacked health insurance and 80.7% lacked a usual source of care. We also found overweight and obesity in 47.1% and 27.1%, respectively, and hypertension in 63.6%. Services provided by the health screening events were up to $239 less expensive than comparable services provided at local health centers. Conclusions: Working directly with the community, we designed and implemented health prevention events which served to meet a growing need and to identify and address health concerns among the Hispanic immigrant community.

Challenges and Lessons from Conducting a Community-Engaged Evaluation of a Community Advisory Board–A Case Study from Flint

Abstract: Community-engaged research often poses challenges due to exactly those qualities that make it desirable: it provides a new model of research that differs in many ways from top-down, university-led, prospectively designed approaches. While many have discussed the challenges to conducting community-engaged research, few have provided precise and generalizable lessons for how to surmount these challenges. Here we discuss the challenges experienced in a project that was community-engaged at three levels: 1) a research team consisting of an academic and a community partner as well as a community and academic research assistant, 2) the research team engaged with a Community Advisory Board called the CBOP-CERB (Community Based Organization Partners-Community Ethics Research Board) throughout the project, and 3) the research involved recruiting community participants from an area with a historical distrust of researchers and research: Flint Michigan. We also discuss administrative challenges that this multilevel community-engagement posed. Most important, we provide practical lessons in order for future community-engaged research to avoid or mitigate many of these challenges.

Beyond the Manuscript: Challenges and Lessons Learned from a Community-Engaged Evaluation of a Community Advisory Board

Beyond the Manuscript: Challenges and Lessons Learned from a Community-Engaged Evaluation of a Community Advisory Board

Inclusion of individuals with Down syndrome in auditory research

This talk will provide an overview of the procedures, challenges, and key findings of Project INCLUDE at Boys Town National Research Hospital. Funded by a trans-NIH initiative to investigate health conditions that affect individuals living with Down syndrome, the goal of Project INCLUDE at Boys Town National Research Hospital is to characterize how speech, language, and hearing develop across the lifespan. Individuals living with Down syndrome have been inadequately represented in auditory research, which has likely contributed to health care disparities. The exclusion of individuals with Down syndrome in prior research is particularly concerning given the high prevalence of hearing loss and otologic disease observed in this population. Results from an ongoing experiment investigating masked speech recognition outcomes will be presented. Participants are school-age children and young adults with Down syndrome and age-matched participants who are neurotypical. Data collection includes clinical audiological measures and standardized assessments of speech, language, and executive function, facilitating comparisons with other cohorts affiliated with the NIH-wide initiative. Recommendations for recruitment, details on the formation of a community advisory board, and community-based testing initiatives will be discussed.

Through the looking glass: empowering youth community advisory boards in Tanzania as a sustainable youth engagement model to inform policy and practice.

More young people are living in the world than ever before, 90% of whom reside in low and middle income countries (LMICs). To address their needs, it is critical to have sustainable youth engagement when determining policy and to advance effective implementation of youth-focused interventions. Youth Community Advisory Boards (CABs) are a sustainable mechanism to achieve this goal. This paper describes engagement with youth CAB members across four locations in Tanzania. To set youth CAB meeting agendas and priorities, we asked youth CAB members to write (using free text) the top five challenges faced by young people in their communities (highest to lower priority). The Google Forms survey link was presented at the May 2023 youth CAB meeting and disseminated through WhatsApp. The survey was completed by smartphone, tablet, or paper provided to the youth liaison for data entry. Results were translated from Swahili to English and coded using excel. Findings were then presented back to the youth CABs at the September 2023 meeting. At that meeting, youth CAB members were then asked to write (free text) potential solutions to the most commonly described challenges. The surveys had response rates of 90% (84/93) for challenges and 78% (71/93) for solutions. The number one reported challenge was unemployment and financial instability (45%). Gender based violence (13%), sexual reproductive health issues (8%), and alcohol and drug use (8%) were in the top four both by priority and frequency of report. Other important challenges included physical and mental health, malnutrition, relationships, education, and societal and environmental norms, among others. Solutions included job creation, improved education, expanded legal systems, youth-friendly health care services, and increased social support through peer networks and community support. The National Accelerated Action and Investment Agenda for Adolescent Health and Wellbeing (NAIA-AHW) 2021/22-2024/25 includes most, but not all, of these top challenges and solutions. Ensuring young people have a seat at the policy table is critical to effective youth-empowerment in health and other related programs. Including a youth CAB member to represent this collective in youth-related government activities is a sustainable model to achieve this goal.

“The spirit of a fighter”: Mixed‐status Latine immigrant families' experiences during COVID

AbstractObjectiveUsing a community‐based participatory research (CBPR) approach, this study documents Latine immigrant families' work, childcare, and education experiences during the COVID‐19 pandemic to inform policy and practice to support Latine families.BackgroundLatine immigrant communities, comprising undocumented and mixed‐status families, were among the hardest hit by the COVID‐19 pandemic. In addition to employment and housing challenges, children and families lost access to the important academic supports and social services built into childcare programs and schools.MethodFor this study, we collected in‐depth qualitative interview data from mothers who were immigrants from Central America and Mexico (N = 23) as part of an ongoing CBPR project. Using community coding techniques, data were analyzed in partnership with our Community Advisory Board, Amigas de la Comunidad.ResultsIn the context of illegality, participants and their families who already feared deportation and family separation, faced added burdens during the pandemic including job loss, school and childcare closures, and isolation. Parents worried about meeting their families' basic needs, getting sick, losing loved ones to COVID‐19, and being evicted from their housing.ConclusionWhile participants shared stories of resilience and resistance, they also reflected on stories loss and hardship—experiences that were exacerbated by anti‐immigrant laws and policies that made navigating the pandemic especially punishing for immigrant families.ImplicationsOn the basis of study findings, program and policy implications for serving Latine children and youth and their immigrant parents, especially those with mixed documentation status, are discussed.

Partnering With Patients With Sarcoidosis to Implement a Community Advisory Board

BackgroundCommunity advisory boards (CABs) are increasingly recognized as a means of incorporating patient experience into clinical practice and research. The power of community advisory boards is derived from engaging with community members as equals throughout the research process. Despite this, little is known of community member experience and views on best practices for running a CAB in a rare pulmonary disease. Research QuestionWhat are CAB members’ views on the best practices for CAB formation and maintenance in a rare pulmonary disease? Study Design and MethodsIn August 2021 we formed the Cleveland Clinic Sarcoidosis Health Partners (CC-HP) as a community advisory board (CAB) to direct research and clinic improvement initiatives at a quaternary sarcoidosis center. We collaboratively evaluated our process for formation and maintenance of the CC-HP with the patient members of the group. Through the series of reflection/debriefing discussions, CAB patient members developed a consensus account of salient obstacles and facilitators of forming and maintaining a CAB in a rare pulmonary disease. ResultsClinician and community members of the CC-HP found published guidelines to be an effective tool for structuring formation of a CAB in a rare pulmonary disease. Facilitators included a dedicated coordinator, collaborative development of projects, and a focus on improving clinical care. Obstacles to CAB functioning were formal structure, focus on projects with academic merit but no immediate impact to patients, and over reliance on digital resources. InterpretationBy centering our evaluation of our CAB on community member experience, we were able to both identify facilitators and impediments to CAB as well as improve our own processes.

Ensuring fidelity: key elements to consider in disseminating a diabetes telemanagement program for underserved Hispanic/Latinos living with type 2 diabetes.

The Hispanic/Latino population has greater risk (estimated >50%) of developing type 2 diabetes (T2D) and developing it at a younger age. The American Diabetes Association estimates costs of diagnosed diabetes in 2017 was $327 billion; with medical costs 2.3x higher than patients without diabetes. The purpose of this manuscript is to describe the methodology utilized in a randomized controlled trial aimed at evaluating the efficacy of a diabetes telemanagement (DTM) program for Hispanic/Latino patients with T2D. The intent is to provide information for future investigators to ensure that this study can be accurately replicated. This study was a randomized controlled trial with 240 participants. Eligible patients (Hispanic/Latino, aged 18+, living with T2D) were randomized to Comprehensive Outpatient Management (COM) or DTM. DTM was comprised of usual care, including routine clinic visits every three months, as well as: Biometrics (a tablet, blood glucose meter, blood pressure monitor, and scale); Weekly Video Visits (facilitated in the patient's preferred language); and Educational Videos (including culturally congruent diabetes self-management education and quizzes). COM consisted of usual care including routine clinic visits every three months. For this study, COM patients received a glucometer, glucose test strips, and lancets. Establishing a therapeutic nurse-patient relationship was a fundamental component of our study for both groups. First contact (post-enrollment) centered on ensuring that patients and caregivers understood the program, building trust and rapport, creating a non-judgmental environment, determining language preference, and establishing scheduling availability (including evenings and weekends). DTM were provided with a tablet which allowed for self-paced education through videos and weekly video visits. The research team and Community Advisory Board identified appropriate educational video content, which was incorporated in diabetes educational topics. Video visits allowed us to assess patient involvement, motivation, and nonverbal communication. Communicating in Spanish, and awareness of diverse Hispanic/Latino backgrounds was critical, as using relevant and commonly-used terms can increase adherence and improve outcomes. Shared decision-making was encouraged to make realistic health care choices. Key elements discussed above provide a framework for future dissemination of an evidence-based DTM intervention to meet the needs of underserved Hispanic/Latino people living with T2D.

Priorities for efficacy trials of gender-affirming hormone therapy with estrogen: collaborative design and results of a community survey.

Treatment guidelines for gender-affirming hormone therapy with estrogen (GAHT-E) recommend specific dosing regimens based on limited data. Well-controlled efficacy trials are essential to tailoring treatment to patient goals as the guidelines recommend. The goal of this study was to take a foundational step toward designing community-centered effectiveness trials for gender-diverse individuals seeking GAHT-E. Our team developed a cross-sectional survey based on broad clinical experience and consultation with our community advisory board. The survey included 60 items covering demographics, transition history, goals and priorities for treatment, indicators of treatment success, sexual function goals, and future research priorities. The survey was distributed during the summer of 2021, primarily through social networks designed for gender-expansive individuals seeking treatment with estrogen. A total of 1270 individuals completed the survey. Overall treatment goals most frequently rated "extremely important" or "very important" were the following: (1) improved satisfaction with life (81%), (2) appearing more feminine (80%), (3) appearing less masculine (77%), (4) improved mental health (76%), and (5) being seen as your true gender by others (75%). The three body characteristics most frequently rated "highest priority" or "high priority" among changes were the following: (1) facial hair (85%), (2) breast shape or size (84%), and (3) body shape (80%). The highest-rated research priority was comparing feminization with different routes of estrogen administration. The goals and experiences of individuals seeking GAHT-E are diverse. Future clinical trials of GAHT-E should be grounded in the needs and priorities of community stakeholders.

Leveraging community advisory boards within travel medicine to help reduce malaria incidence in refugees, immigrants and migrants visiting friends and relatives abroad: reflections from the Minnesota Malaria Community Advisory Board on patient-provider interactions.

Refugees, immigrants and migrants often have barriers to travel medicine. Community Advisory Boards (CAB) are a vital but underutilized tool for understanding and meeting healthcare needs and challenges, providing communities with a voice, and finding solutions. The paper discusses a malaria prevention community-based participatory research project informed by a CAB.

Bridging the Gap: A Community Advisory Board Promoting Community Engagement in Cancer Research for Ethnically Diverse Populations.

Prostate cancer disproportionately affects Black men in the United States, leading to higher mortality rates and health disparities. In addition, based on historical mistreatment and discrimination and the resulting distrust of the medical system, Black populations are consistently underrepresented in health care-related research. Addressing these challenges requires community-driven approaches integrating diverse perspectives and fostering equitable health outcomes. This article describes the formation and impact of The Multidisciplinary Health Outcomes Research and Economics (MORE) Lab Community Advisory Board (CAB) at The University of Oklahoma Health Sciences. We purposefully recruited Black men with CaP and Black health care professionals to serve on a CAB and advise on ongoing research to address quality of life (QoL) issues in ethnically diverse Black CaP survivors. The CAB seeks to mitigate CaP disparities and improve health equity by empowering Black voices and promoting collaborative research practices. The MORE Lab CAB has successfully provided a venue for community members to contribute to designing a culturally relevant research program to improve the QoL in ethnically diverse Black men with CaP. The CAB has been instrumental in developing research goals and tools, implementing a series of town hall meetings to educate and support Black CaP survivors, and disseminating research findings. In conclusion, CABs are potentially critical in guiding research, enhancing community engagement, and advocating for culturally responsive health interventions.

Conducting Community-Based Research in An African Immigrant Population: Lessons Learned

Background Although small, the African immigrant population is one of the fastest growing immigrant populations in the United States. Emerging research indicates a high prevalence of noncommunicable preventable chronic conditions in this population. Like other African Americans, African immigrants are mistrustful of the health care system, hampering efforts for prevention and intervention research. Purpose To describe our experiences conducting 2 studies in an African immigrant community, discuss the lessons learned, and provide advice to researchers interested in conducting research in similar populations. Design The 2 published studies for which we derive lessons learned for this paper were a cross-sectional study and a qualitative study using focus group interviews. Participants included Zimbabwean immigrants in the Eastern United States recruited at religious festivals and community events. The 2 studies enrolled a total of 135 participants. Results Of our recruitment goal of 120 in the first study, we enrolled only 98 despite numerous efforts. However, after strategically partnering with a community advisory board (CAB), in the second study, we met our recruitment goal within 4 months. With the CAB, we recruited a larger proportion of men (38% versus 24%). Without the CAB, 350 individuals agreed to participate, but only 98 (28%) returned the questionnaire, whereas with the CAB, 40 agreed to participate, and 37 (93%) successfully completed the study. Conclusion Conducting health-related research in immigrants requires strategic partnerships with the community to build strong relationships between the research team and the target community. By nurturing these relationships, research teams can effectively access this hard-to-reach population and achieve high participation.

Abstract B085: Increasing utilization of breast cancer risk assessment tools: Identifying and adapting implementation strategies using multiple stakeholder groups

Abstract Background: Each year ~12,000 female breast cancers are diagnosed in US women ages 18-45 with overrepresentation of aggressive cancers, advanced stage disease at diagnosis, and inferior outcomes. The American College of Radiology and American Society of Breast Surgeons recommend that breast cancer risk assessment (RA) start no later than age 30 to identify high-risk individuals in whom to initiate screening earlier. However, RA tools are currently utilized in as few as 3-26% of eligible women. Methods: Our study aims are to assess feasibility, reach, acceptability, and appropriateness of customized strategies to increase uptake of breast cancer RA. We identified barriers to increasing utilization of RA tools through discussions with long-term community partners in the Tennessee Breast and Cervical Cancer Screening Program (TBCSP), a three-phase adapted Feasibility of Intervention Measure (FIM) in five health clinics, and one-on-one interviews guided by the Consolidated Framework for Implementation Research with 24 providers in public health settings and 37 interviews guided by the Health Belief Model with Black women age 30-50 years with no personal history of breast cancer. Interview data contributed to the development of a conceptual framework to depict influences of provider behavior in the utilization of breast cancer risk assessment. Using the CFIR-ERIC Matching Tool and working with the study’s Community Advisory Board (CAB), the research team identified three potential strategies to increase the use of breast cancer RA in public health settings. Findings: Selected strategies included having a site champion for each clinic, offering a short series of education modules, and distributing print educational materials including a provider education sheet and patient-facing information cards. These strategies were further revised in collaboration with the CAB and patients and providers in Community Engagement Studios. Implications for D&I Research: This project demonstrates the contributions of a long-standing relationship with a state-wide public health agency, implementation science tools, and collaboration with community advisors for identifying and addressing barriers to breast cancer RA. The study has generated replicable scripts for educating providers and community-informed reproducible patient education materials to increase breast cancer RA. Evaluation of the impact of these strategies on provider behavior in six clinical settings is currently underway. Citation Format: Rebecca Selove, Lucy Spalluto, Maureen Sanderson, Laura Ernst, Carolyn Audet. Increasing utilization of breast cancer risk assessment tools: Identifying and adapting implementation strategies using multiple stakeholder groups [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Breast Cancer Research; 2023 Oct 19-22; San Diego, California. Philadelphia (PA): AACR; Cancer Res 2024;84(3 Suppl_1):Abstract nr B085.